| Riverside Family Practice | |
|
105 E Burlington St Riverside IL 60546-2146 | |
| (708) 442-0333 | |
| (708) 442-9863 |
| Full Name | Riverside Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 105 E Burlington St, Riverside, Illinois |
| Authorized Official Name and Position | Edward Tong (PRESIDENT) |
| Authorized Official Contact | 7084420333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Family Practice 105 E Burlington St Riverside IL 60546-2382 Ph: (708) 442-0333 | Riverside Family Practice 105 E Burlington St Riverside IL 60546-2146 Ph: (708) 442-0333 |
| NPI Number | 1154367639 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 11/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154367639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036084251 (Illinois) | Primary |
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